Waves of pain across Michigan’s ‘Disability Belt’

Across northern Michigan, a greater percentage of working-age adults are getting long-term disability than anywhere outside the rural South. In a region beset with economic and health woes, tens of thousands of workers have qualified for checks at a rate unrivaled north of Kentucky.

Source: U.S. Census, Social Security Administration and the Bureau of Labor Statistics.

When she was in her 40s, Jolene Mcclellan worked full-time at a retail store and rode motorcycles and pedaled bikes in her spare time.

Three back surgeries later – and with cerebral palsy symptoms worsening – Mcclellan is disabled, relying on a wheelchair and living with constant pain throughout much of her body.

Now nearly 60, she said she hopes to supplement her monthly disability checks by landing a part-time job, maybe answering phones or doing computer work, though she has no use of her right hand from her cerebral palsy – and the recent onset of multiple sclerosis.

“I never knew I was going to get to this point. I never expected it. Not at my age. Not at 59,” Mcclellan said. Her last job, nearly 15 years ago, meant working on her feet for eight hours despite a metal brace on her right foot. “I know people who are 80 who get along better than I do.”

Mcclellan lives in the tiny village of Kingsley, north of Cadillac, on the fringe of an area known darkly as Michigan’s “Disability Belt.”

It’s a label most commonly applied to a wide swath of workers extending from the Deep South up through Appalachia. It signifies a region where post-recession aging workers in poor health and with few prospects for work have turned to federal disability benefits as a last resort, a replacement income for their long-lost unemployment checks.

Less well known is that an area consisting of 17 northern Michigan counties – mostly in the upper Lower Peninsula – qualifies as a separate strand of this Disability Belt, with economic distress nearly as overwhelming as in rural sections of Arkansas, Alabama and West Virginia.

Across this region, an area plagued by persistent unemployment and poverty, a surprising number of desperate workers have turned to Social Security disability benefits to earn a livelihood. Many don’t expect to return to the job market – unless federal investigators throw them off disability rolls.

In some counties, rates of poverty and disability hover around 15 to 20 percent, raising questions about whether a some portion of working-age residents apply for disability as much from despair that they will ever land another job as from physical necessity.

Advocates for the disabled say that is not the case, noting strict eligibility requirements for federal assistance and the fact that most applicants for disability are rejected. But that view is not unanimous.

One of the nation's leading experts on the disability program, economist David Autor of the Massachusetts Institute of Technology, argues that medical advances and improved equipment that can help the disabled return to the workforce are ignored by the Social Security system.

David Autor, an economist at the Massachusetts Institute of Technology, is a leading researcher and critic of the current system for disability insurance.

"Social Security Disability Insurance is ineffective in assisting workers with disabilities to reach their employment potential or maintain economic self-sufficiency,” Autor noted in a report he co-wrote in 2010. “Instead, the program provides strong incentives to applicants and beneficiaries to remain permanently out of the labor force."

A new version of early retirement

Northern Michigan is part of a national phenomenon that emerged two decades ago and especially during the Great Recession of 2008-10, when an abrupt decline in blue-collar jobs left certain workers – mostly in their 50s, suffering from chronic medical conditions – unemployed or underemployed for years at a time.

“Good luck finding a job when you’re 52 years old and can’t lift anything or stay on your feet for hours” ‒ Gary Kozma, a disability attorney in Gaylord

They dealt with persistent pain, often job-induced, and eventually found themselves unable to lift heavy items, stand for hours at a time, or even efficiently climb stairs.

With jobs in manufacturing, construction and similar manual labor beyond their reach, these economic outcasts also held little chance of landing employment in the region’s fragile retail sector or service industries. Armed with a high school diploma or less, they were unlikely to find office work.

So, they turned to the Social Security system’s disability insurance.

Gary Kozma, an attorney based in Gaylord who specializes in disability cases, said Social Security checks for the disabled have become almost a form of early retirement in some rural areas where older, unskilled people with debilitating health problems can’t find work.

They may not suffer from the severe disabilities Jolene Mcclellan faces, but they realize their job prospects are dim. Physical and economic pain are a way of life.

Attorney Gary Kozma of Gaylord said he has seen firsthand the despair of battered workers who can no longer find jobs.

“I think when the economy is bad, when there are no jobs to be found, these people think, ‘Maybe I can get disability,’” Kozma said. “Most people still want to work but the (system) realizes … good luck finding a job when you’re 52 years old and can’t lift anything or stay on your feet for hours.”

Kozma said the federal system places disability applicants in categories, a “grid system” based on age and physical condition and essentially draws a dividing line at age 50 – workers at or above that marker have a much better chance of qualifying for disability benefits than the younger age group.

Those who successfully navigate a system marked by bureaucratic red tape, waiting periods of about two years and can prove their condition prevents them from taking available jobs will receive a monthly check, on average, of about $1,165, according to 2015 data.

Possible changes afoot

The payments are meager yet the number of people receiving disability nationally has risen sharply in recent years, in part due to aging Baby Boomers and millions of women who joined the workforce in the 1970s and now approach retirement age.

In Michigan, approximately 385,000 working-age people receive some form of disability benefits, and the monthly payout across the state is $425 million, according to federal disability data.

While a majority of applicants for disability insurance are rejected, those who make it onto the disability rolls receive a lifeline in the form of a monthly check and qualify for Medicare health care coverage after a 2-year waiting period. Often as important, many people with disabilities, depending on their household income, qualify for Medicaid during those initial two years.

At least for now.

In Washington, federal budget cuts proposed by President Trump are accompanied by continued interest on Capitol Hill in chopping Medicaid funding, despite the implosion last month of the Republican replacement for Obamacare, the American Health Care Act (AHCA).

The proportion of U.S. workers on disability benefits has more than doubled since 1990, from 2.5 percent that year to 5.2 percent in 2015 – and now totals about 9 million recipients. Michigan has the nation’s 8th-highest disability rate at 8.6 percent.

Bleak times for northern Michigan

In the state’s Disability Belt, the picture is far more bleak. The affected counties have disability rates of 12 percent or higher, according to the Social Security Administration. Advocates for this population contend the true rate is likely far higher.

Many more people between the working age of 18-64 have told the Census Bureau they have a disability, though they receive no government compensation. Those who work inside the system say many with disabling conditions either decline to apply for benefits or they were rejected by the daunting application process.

In Roscommon County, the area around Houghton Lake, nearly 1-in-4 residents (23.5 percent) lives in poverty. In 2015, roughly 24 percent of residents surveyed by the Census Bureau said they suffer from one or more disabilities. In Montmorency County, between Gaylord and Alpena, 20.8 percent live in poverty and 23.5 percent told census takers they have a disability. In Lake County, 29.9 percent live below the poverty line and 22.4 percent reported a disability.

A rural refrain

Geography, demographics and economics converged to create the Michigan Disability Belt, according to Kathleen Romig, a Michigan native who studies federal disability programs for the Washington-based Center for Budget and Policy Priorities (CBPP).

What these counties have in common are ills afflicting rural communities across much of the nation: an aging population, a rise in middle-age death rates (especially among whites), depressed home values and young people who, once they earn a college degree, flee for urban settings such as Detroit, Grand Rapids or Chicago.

“A rural county in northern Michigan with an older, less educated population and more blue-collar jobs would have a higher rate of (disability insurance) than Washtenaw County, with its many students, professors, etc.,” Romig said.

In the relatively prosperous communities along the Lake Michigan shoreline where disability rates are average, such as Leelanau, Grand Traverse and Emmet counties, more than 30 percent of the population age 25 or older holds a college degree. In nearby counties in the Disability Belt – Kalkaska, Missaukee, Wexford – college-educated rates are half that percentage or less.

As Bridge has reported, the fall-back position for struggling workers in northern Michigan often involves seasonal positions in the tourism industry, or temporary work in home repair or landscaping. They are often outdoor jobs, where physical limitations lead to income limitations.

Even among skilled workers in more vibrant metro regions such as Detroit, age can be a barrier to employment.

For a northern Michigan worker with a broken-down body, especially those 50 or older, they are often labeled as unemployable. Advocates for the disabled say these people are weeded out from the hiring process by subtle discriminatory practices based on age and ability, or they fail to keep their jobs due to physical constraints.

Blue collar jobs disappearing

The changing economy in northern Michigan ‒ as far as the tip of the Upper Peninsula, where disability rates are also high ‒ has dramatically impacted workers over several decades, said Charles Ballard, a Michigan State University economist.

Mining and lumbering industries are mostly gone. Manufacturing was never a significant presence. In agriculture, while Michigan crop yields remain strong, the farming sector is shrinking and offers fewer job opportunities for unemployed workers who once toiled in manual labor.

“Not many new people migrate into the region, and these things feed back on themselves,” Ballard said. “But … the question is, where would they be without DI? If good jobs are hard to find, then the alternative to DI might well be an even lower income.”

At the same time, federal budget cuts proposed in Washington could disproportionately hurt low-income people, especially those on disability rolls. President Trump’s first-year budget proposal would eliminate four federal block grant programs that assist seniors, the poor and the disabled with affordable housing, home heating bills, public transportation and other anti-poverty services.

Jim Moore, executive director of the nonprofit Disability Network Northern Michigan, said his clientele would also feel the effects of proposed presidential cutbacks to Meals on Wheels, in-home nursing visits and other programs that allow independent living for the disabled in their own home. Rural hospitals in Michigan have told Bridge they could face financial peril or even closure if the Affordable Care Act is repealed or restricted.

Jolene Mcclellan, 59, of Kingsley, receives disability payments while she continues to search for work she can perform despite constant pain (Bridge photo by John Russell)

“We’re very concerned about anything that would take away … from those safety-net programs that are critical to people’s well-being,” Moore said.

The federally funded expansion of Medicaid eligibility under the ACA, also known as Obamacare, may be particularly susceptible. Gov. Rick Snyder recently warned that “our most vulnerable citizens” would suffer if the expansion, known as the Healthy Michigan program, and those in 30 other states that took advantage, is eliminated.

A report released in March by the progressive-leaning Center for American Progress found that 41 percent of Michigan’s 609,000 Medicaid recipients with disabilities would have been affected adversely by the failed Republican replacement legislation known as the American Health Care Act (AHCA). The center concluded that any significant reductions to the Medicaid program would force some of the disabled out of their homes and into institutional settings, such as nursing homes.

Rebecca Vallas, director of the center’s “Poverty to Prosperity Program,” argues that removing large numbers of the disabled from Medicaid coverage will end lives.

“People, absolutely, will die,” Vallas said. “This will mean actual deaths and destruction for people who, in many cases, have access to these services for the first time in their lives.”

Two types of disability

Within the federal framework exists two kinds of disability, and two kinds of recipients

One broad category of disability recipients includes victims of accidents or debilitative diseases ranging from cancer to congestive heart failure and multiple sclerosis, as well as developmental disabilities. The blind and deaf also encompass this group.

The second ‒ and far more contested and controversial ‒ disabled population is dominated by those with “musculoskeletal” problems such as a failing back, knees or hips, and those with some form of mental illness. Other factors such as severe high blood pressure, obesity and diabetes often come into play.

People apply through one of two federal disability programs: Social Security Disability Insurance (SSDI), an earned benefit program for those who accumulate work credits whose payments are linked to their average earnings before they became disabled, and Supplemental Security Income (SSI), which is based more on financial need, regardless of whether you worked or paid into Social Security.

Eligibility depends on whether an applicant can no longer achieve “substantial gainful activity” in the labor market. The rapid rise in disability insurance is mostly associated with musculoskeletal conditions and those with mental illnesses, including chronic anxiety, depression and memory loss, categories that critics say can be too subjective.

Because many of those conditions remain difficult to prove, even with documentation by a physician or specialist, only about 40 percent of applicants make it through the application process, and a backlogged appeals process, without being rejected.

In recent years, Washington has begun to crack down on disability fraud. In 2014, the Social Security Administration (SSA) opened a new Michigan anti-fraud unit based in Detroit that works in conjunction with the state Department of Health and Human Services.

In fiscal year 2016, state officials said the unit handled 115 investigations that saved an estimated $11.8 million in costs for the disability program, Medicaid and Medicare.

The SSA’s Office of Inspector General shifted most of its enforcement emphasis, nearly 90 percent, onto disability cases. Yet, advocates note that the focus on fraud belies the fact that the SSA removes only about 1 percent from the disability rolls each year.

Is fraud overblown?

Disability advocates in Michigan say their clientele deal with a “scary environment” of critics who view disability insurance as a welfare program loaded with fraud.

Two recent attempts at aggressive oversight of people receiving financial help from the government produced embarrassing results for state officials. A drug testing requirement for those on welfare produced no offenders. A clampdown on those receiving unemployment checks led to a bungled state computer system failure that falsely accused thousands of workers of fraudulent activity.

Meanwhile, a bill introduced in Congress earlier this year by lawmakers from Arkansas would limit some people to two years of disability benefits.

Norm DeLisle of East Lansing, a disability advocate since 1970, said he has witnessed a half-dozen waves of politically driven efforts to remove people from the disability rolls in his career. Because government health care costs associated with the disabled are far more expensive than for healthy recipients of programs such as Medicaid, DeLisle said, lawmakers tend to target the priciest recipients, labeling them as the beneficiaries of outsized care.

“We have these naïve policy people who think they can reduce costs by targeting people who are the most expensive to care for and reduce their coverage by, let’s say, 5 percent. They think of it in the same way that they decide what new car they should get,” said DeLisle, former director of the Michigan Disability Rights Coalition and now a consultant for the organization.

Academics who study the nation’s disability program say few solutions exist to provide greater incentives for disabled workers to return to work. Disability payments are usually permanent; a worker’s paycheck can disappear at any time.

Reforms proposed by SSA have come and gone. Autor, the MIT economist, who coined the term “Disability Belt,” has proposed private disability insurance that encourages employers to find way to get disabled workers back on the job. A pilot program known as Project Search has achieved success in Michigan transitioning young adult special education students into the workforce.

But perhaps the ultimate solution is to let trend lines run their course. As Baby Boomers reach retirement age, the number of new disability applicants nationwide has dropped for several years. Advances in medical treatments and physical therapy could also make an impact.

Romig, the native Michigander who studies disability for the CBPP, said reality must set in for policymakers. About 35 percent of disability benefit recipients are age 60 or older, and 75 percent are age 50 or older. All are approaching retirement age.

Many of these people, she said, did not suffer temporary injury that could eventually put them on a path to recovery. Their persistent, worsening health conditions led to the day when they were labeled unemployable.

That would include people like Jolene Mcclellan, the woman from Kingsley. A nearby nonprofit group helps Mcclellan search for some type of work, perhaps a position that involves a few hours a week, where her husband can provide for her transportation.

“I still want to feel like I’m contributing to society,” Mcclellan said. “It really aggravates me that I can’t do what I used to do – simple things.” Her voice trails off.

Romig said people like Mcclellan are far more common than work-averse cheats trying to game the system.

“By the time a person meets the strict standards for disability insurance, it’s often too late,” Romig said. “Their health has simply declined too much, and they are no longer able to support themselves and their families.

“Even under the best of circumstances, it’s hard for workers to reinvent themselves at age 60. For workers with disabling health problems ‒ especially when combined with limited education and skills ‒ it can be impossible.”

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Comments

Mike Bauer

Tue, 04/11/2017 - 8:55am

There are no easy answers here. While I’m sure there is fraud that occurs, the number of people on disability is staggering - the majority of these cases can't be ascribed to fraud.

The rate of disability seems to be correlated with economic opportunity or the lack of economic opportunity. Is this the case? Where there are opportunities does the fact that there are jobs, insurance, healthcare, etc. have an impact? What about education? Reading through the case here it seems that many times this could be prevented with early care, proper diagnosis, exercise, etc.

Given the fact that the country is now in the throes of an obesity epidemic will we see more of this? Obesity makes it harder and harder to get around and a sedentary lifestyle creates even more problems.

As a society, we do not seem prepared to the real shift that has occurred about the make-up of work, lifestyles, etc. While it has only been a few generations we have yet to adapt to it

Good questions. Northern Michigan has suffered from chronic unemployment for many years, in part because of its seasonal job market. Nobody wants to see individuals who legitimately are disabled suffer loss of, or be denied, disability benefits; but, the fact remains that there are people receiving benefits whose health conditions are suspect. I, for one, do not believe individuals should receive disability benefits because jobs are not available.

Mike:
I'm glad to see that this article has got you thinking a bit. If you re-read this article a couple of times, you will realize that a person can't get Disability Insurance without passing through a lengthy and pervasive screening. Yes, none of us taxpayers wants to be the victim of fraudulent claimants, but it is more likely that a lot of folks who ought to obtain this help are being denied, because of public fears that the program is being exploited. And yes, American eating habits have changed greatly for the worse over the past 40 years. Robert Pollan in his book: The Omnivore's Dilemma did an excellent job of tracking the reasons that this has happened. But you can't reasonably expect that folks who are marginally educated and employed will ever understand and be able to effectively respond to that syndrome. Physical therapy could probably enable a lot of these folks to get back on the job (if there were jobs), but effective physical therapy is rarely available under Medicaid's limited reimbursement system. These folks simply do not have access to the kind of information and understanding that you are presuming.

Ben, let me pushback a little, in particular about access to information. The information is commonly available and to a certain degree it is incumbent on the individual to take some responsibility for their health.

Yes, there is quite a vetting process that occurs and there is also a cottage industry of attorneys and advisors to help navigate the labyrinth of organizations and regulations. I believe that everyone who needs them should have access to disability benefits yet it is in everyone's best interest; jobs available or not, to get healthier and relieve their pain and discomfort

And we wonder why the Social Security system (and Medicare) is going bankrupt as every study points to the inability to pay benefits in the not so distant future. For some in this article, the main disability is that they have become too comfortable and have lost the desire to work.

They are not going bankrupt. There is a ten year period they only have 80% of the money for. A simple cap adjustment would take care of that. It's been done before. But now we have rich guys that want every dime.

Since when has CBS news ever not been part of the "Washington Consensus" ? Only radical conservatives and libertarian wing nuts continue to maintain that the mainstream media sources like CBS, NBC, ABC, NPR are not thoroughly center-right corporatist in their editorial outlook.

A large amount of the Michigan disability and unemployment area is represented by John Moolenaar, who is in favor of killing the current health care plan developed under President Obama in favor of the one developed, or under development, in the currant House by Ryan and associates which appears to make things worse for his constituents.

A little test for anyone interested, take a walk out on to a frozen lake in northern MI on any weekday and chat with the ice fishermen, half of them will be on unemployment or disability. Same goes with much more vigorous hunting or other fishing pursuits. Then throw in a huge number working for cash. I've had extensive experience in this and clearly there are true cases but most people can talk themselves into or out anything of when given the opportunity.

Only people who don't fish think that fishing is a realistic cost effective way to feed your family! If someone can walk across a frozen lake, chop holes in the ice, sit all day in the cold, not to mention hunt deer and drag them out of the woods and you are going to tell me there's no way this individual can not work at any other job? It appears I must be hitting someone in a tender spot?

I know someone in Lansing who has been on disablity for around 30 years, he had a stroke
while mowing his lawn and now has limited use of one arm, his speech is slurred and he often loses track of the subject he is talking about, thankfully he is not in a wheelchair and can still walk and get around OK.

"About 35 percent of disability benefit recipients are age 60 or older, and 75 percent are age 50 or older. All are approaching retirement age."

Disability + ageism = unemployment and ageism by itself= unemployment. What DO you do when you are laid off at age 50 + and no one will hire you because you are, in their opinion, too old? I read about employers continually complaining bitterly that they can't find people who have skills (CNC, engineer, IT, customer service, you name it) and a good work ethic. Yet these same employers only want to hire people under 35.

We have a current crisis which will be getting worse as society ages. Financial gurus tell people to work as long as possible, but when employers refuse to see the value in older workers and/or put their heads on the chopping block first when cutting jobs, what, exactly, are people who have been kicked to the curb supposed to do? Try to get disability or just starve? Great choices, huh?

They say they are looking for capable and dedicated older workers but don't follow through and actually hire them. They prefer to hire younger workers who are probably still living at home with their parents, don't care about benefits, and will presumably accept less pay. I am college educated with a solid resume of strong work performance. I speak from experience.

I absolutely feel for people with legitimate disabilities. I couldn't however read this article without thinking about my own experience with employment in Alcona County. We own a property there that we rent out in the summer and I can't tell you how difficult it has been trying to find a person to clean it. I advertised on craigslist for months and months and asked dozens of people before I finally found someone last year. I paid $25 an hour cash for 4hr/wk which is probably unheard of up there but we were willing in order to find and retain someone . We had many many inquiries but most were no-shows at interview time. So when people complain about no work up there it makes me wonder! Granted, we weren't offerering a full time job but certainly $100 every week in the summer should gave interested more than a couple of people.

I find this same phenomena to be the case in many places in Michigan and not particular to Alcona County. I have found it difficult to find odd job workers for short term employment in numerous Michigan localities. I suggest you not jump to any conclusions about workers with or without disabilities based on the inability to find short term employees.

12 year olds can earn more mowing lawns?! Where do you live?! As a professional in Northern Michigan I make that! Alcona is right...it's the work force in Northern Michigan. It's cheaper to live here so we become the disability belt. I've known people on Disability that truly are disabled - I'm glad it's there for them. And I've know people that are totally capable of employment - we can't afford that. The system is flawed.

That's a damn loaded comment right there! In cases where people have been thrown off of Disability, they are STILL disabled, so there are still no jobs for them and the only future left for them is literally starving in homelessness.

You can't kick out the wheelchair from under a person who cannot walk and then expect them to suddenly stand up and run.

Michigan is full of engineers and technical skilled workers who worked high paying jobs or nurses or put their kids through college now in Chronic Health Problems including pain in my spine are sometimes too overwhelmed with dealing with getting proper treatment or proper equipment to improve their health and mobility. In Michigan it is hard to get a ride to the doctor, ride to pharmacy, ride to grocery store because you cannot drive or how far away is the doctor and the entire insurance industry fighting to pay for anything. When our health as human beings is good then we are productive, please stop punishing people as if they do not want to be productive. Physicians should treat the entire human being including mental health because it is hard to be productive when you cannot control your body.

Why would the feds throw them off?! It isn't fraud. Many Urban folk that have a disability can find other work, such as answering a phone, that's not available in rural areas. They therefore legally qualify. This is insurance.

Yup. They can become telemarketing gurus. I keep my house phone unplugged unless I want to use it and I get calls daily from all over the country on my cellphone trying to scam me out of money. I worked 40 years until two accidents took me out. I was denied at first. 80% are and then it takes 2.6 years to get a hearing. Try going for that long without funds and see how you can even get rehabilitation for your injuries. By the time my hearing rolled around 3 physicians wrote that my disability was permanent. Since I will only receive my full retirement pay from social security I can't see how this is a big win since I was an executive making over $100k per year prior. Seems like a lot of criticism from our fellow man without walking a mile in each other's shoes.

I am so glad you wrote this - until you have had your whole world destroyed by injury or illness, until you have blown through all your savings, your 401k, cashed in your insurance policies, until you have mortgaged your house - twice - to keep up with the medical bills, until your spouse had to put you on their individual health insurance and had to pay the $670 a month via a VISA card (that you still have $6k of the $12k debt to repay), until you've been hung up on by multiple private insurance companies, until your ex employer offers you COBRA at $970 a month when your private disability coverage is only $1300, until you had to wait 3 years and been denied twice for a disability hearing, until you've been diagnosed with cancer at 49, until you've lived with high strength pain meds that would make you jail material if you were pulled over driving, until you had a TIA due to the cocktail of those meds, until you've had 100+ nerve block injections and come to know your local PT folks by their first names, until you FINALLY qualify for Medicare - keep your intolerant, uncaring thoughts and criticism to yourself. There but for the grace of God .....

Thank you.
The average healthy, able-bodied individual has no idea.
I've been living with the same genetic disease since childhood. I pushed hard and fought for a normal life. It was never quite normal, but good enough. I'm in my late 30's and my condition is deteriorating rapidly. I'm still employed but hanging on by my finger nails.
I am one of the lucky few who has private long-term disability insurance through my employer. However, the terms of that insurance stipulate that I must apply for SSDI and it is in my best interest to do so, because even after declaring me permanently disabled, they can change their mind at any time and stop making payments. It doesn’t come with any benefits, It's just over 60% of my current income. I would still have to pay taxes and all of my bills. In an average month I have $8,000 in health expenses, that's just for me, just for meds and lab work, when things are relatively stable. Then add on the team of specialists, the imaging tests, the surgeries, etc. Medicare is expensive and best-case scenario I’d have to wait 4-5 years for it (2.5 for SSDI, another 2 for the waiting period). To qualify for Medicaid I would have to give up everything I have worked so hard for, every asset. It's like declaring bankruptcy except you didn't do anything wrong and it's not a fresh start, it's a life sentence. I could afford decent subsidized health insurance on the exchange, but I’m not feeling very warm and fuzzy about relying on that. I am watching the debate over the ACA with absolute dread that when I need it, health insurance won't even be an option.
I'm still working, barely, but doing so is actually making my condition worse, causing permanent and irreversible damage that is taking years off my life. Sadly, I don't care about that.
I care about being able to pay my bills and put food on the table now and a year from now, not making it to the “golden years.” I am sick with worry that any day my employment will be terminated and then I won't even have the option of using private disability insurance. It is a catch-22.
I used to judge too. Actually, if I'm being perfectly honest, I still judge people on disability a bit. I still judge, even after my employer has told me that I should take disability, while I still can; even after my doctors have told me that I should be starting the process. I fear for my financial security and my healthcare (people die waiting for disability benefits). I dread what being “disabled” will do to my self-esteem and to my relationships because we are all brainwashed to believe that disabled people are, at best, a burden. It’s a dark place and I don't want to end up there.
So as I read comments on this article and others like it, I am darkly amused by the pervasive attitude that people want to be disabled. I get it, every time I harbor these thoughts I have to remind myself how disconnected from reality we must be to think that getting and staying on disability benefits is desirable. That people want to give up all their assets and live on a tiny fixed income that may or may not be relied upon in the near future. That they want to worry about how they'll pay for healthcare. That they want to live with the self-esteem and social issues that result from the stigma of being disabled.
I suspect that the average reader has no idea how difficult it is to get SSDI. Years of not working while sorting through red tape, seeing specialists whose job it is to prove that you’re faking, meeting with attorneys and going before judges to make your case. There are almost certainly people collecting benefits whose predicament is more an indication of our economic and social ills than a complete inability to work, but I would wager, based on what I’ve seen, that there are many more genuinely disabled people who have been denied benefits.
There does need to be a viable path back to work for those who are able to do so.
Being "stuck" on disability isn't good for anyone. The system is broken but it’s not because benefits are too easy to get or too generous.

This problem is part of a larger set of issues that have to do with our failure to have developed a comprehensive national health insurance and care system that would have probably caught and provided preventive treatment for many of the ailments that are now disabling people. (read the book "Anatomy of an Epidemic" by Robert Whitaker for a history of the scandalous way that mental health issues have been treated by the psychiatry profession in the last 50 years that has resulted in ever higher rates of psychiatric disability, but has made pharmaceutical companies and their pet doctors very wealthy.) It is also related to the fact that as a nation we have done nothing to promote effective economic and job creation for less skilled workers in rural areas. What we have done instead is to provide endless tax incentives to politically connected corporations who have rented both local and federal legislators as needed and rarely if ever actually delivered the promised jobs and economic development. We need the type of programs that FDR created during the Great Depression that actually put people into real productive activity -- god know there is enough that needs to be done in the state and nationally.

In view of the emphasis on disability claims in outstate Michigan, it would be useful to know how many were outstate residents at the time the claim for disability was initially made as opposed to those who started receiving disability payments and then moved to where the cost of living was cheap and the lifestyle more to their liking. Many retirees move up north, and I would expect that would be true of those with a disability also. The article implies that disability claims are more prevalent outstate, but it is hard to tell if the claims originated outstate without more information.

Two points here
First, many if not all of these "belt" counties have the lowest housing cost in the state. Lake county and Calhoun county both have towns with extremely low rents and property values. This explains the heavy population of benefits. These people are trying to exist on a fixed income. Of course they go where housing is the cheapest
Secondly, at age 55 and an avid walker my whole life, my dog was caught in a trap in a public cemetary. Trying to get her out my femur bone broke under my knee cap. This knee injury spiraled my life into a huge giant suckfest. 9 doctors later with 5 specialist and one knee surgery, I haven't been able to walk for 9 months now. I turned in my doctor's note at work and was fired immediately. So to summarize, still can't walk, medical bills up the wazooo, had maintained an extremely healthy lifestyle,
11 months of physical therapy completed , going to U of M in 10 days. The idiot who put an illegal trap in a cemetary? Well I am sure he is taking long walks with his dog, riding bicycle, canoeing, camping, holding his lover's hand on dreamy night walks, shopping, and making plans for the summer. Me? Not so much.

As the owner of a private disability insurance policy stories like these encourage me to continue paying the premium until I retire at 65 - God willing. I have talked with many of my fellow baby boomers about this type of coverage over and above what i employer provides. Almost to a person they will not look into protecting themselves.

I understand not everyone can afford this coverage but when receiving benefits from the government is what you have - don't expect much. If you don't look out for yourself no one will. And that includes the lawyers telling prospects on tv that they should file for benefits they "deserve."

I don't live in the northern counties that have higher disability claims but I am on disability and have been for the last 10 years due to working my body to death in the factories I worked in.....it took me 3 1/2 years to get my first disability check while in the meantime my husband and I had to file bankruptcy because of all the medical bills we couldn't pay....to say that most of these people are "faking it" does a disservice to the people who actually have to practically go under financially in order to receive a monthly check that is 1/10th of the pay I received when I was working.....What you "people" need to realize that filing for Disability is a painstaking process that yields little in benefits........I have Medicare.....and also health insurance from the husband's job....I'm luckier than most people who only get Medicare...I can tell you that Medicare pays for some of the stuff I need....I take 9 medications a day...we have a medical savings account through my husband's shop...when he retires next year...our scripts will have to come our of our SS checks!! And don't even talk about Medicare part d....no thanks......costs more than my co pays!!!! So before you go talking about people who are trying to game the system remember....you need to do some fact checking before you spout off!!!!!!

I'm wondering to what extent the "disability belt" is a mere reflection of no-job places where anyone who can leave has left. In other words, it's not that a higher proportion of the 2000 population is now applying for benefits, it's that many people who lived there in 2000 left, so the disabled form a larger part of the 2018 population.